Medicaid Fraud to Get Scrutinized

With the federal government trying to cut costs and crack down on fraud, a congressional panel this week will set its sights on the Medicaid program, which last year paid out nearly $22 billion in error or fraudulent claims. 

The April 25 hearing from the House Oversight and Government Reform Committee is just the latest in a series that Congress has had recently targeting federal program that have high “error rates” in payments, such as Medicaid. These errors can be outright fraud or clerical mistakes that ended up costing the federal government billion last year. 

Among the state officials slated to testify Wednesday are Lucinda Jesson, commissioner of the Minnesota Department of Human Services and Gabriel Feldman, a Medicaid official with the New York County Health Services Review Organization. 

One topic that may come up during the hearing is a $30 million contribution to Minnesota from UCare, one of four large HMOs hired by the state to manage care for Medicaid enrollees, the St. Paul Pioneer Press has reported. 

The payment from UCare came after Governor Mark Dayton asked the HMOs to voluntarily give back some of the profit made from handling the state’s health plans in 2010 and 2011, TV station KARE 11 reported. The payment was termed a “donation” but was also referred to as a refund by others and some have questioned why the federal government didn’t get a cut of the $30 million payment since it jointly funds Medicaid, which provides coverage for low-income and disabled residents. 

The official title of the hearing Wednesday is “Is Government Adequately Protecting Taxpayers from Medicaid Fraud?”